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Background: Acute febrile illness (AFI) is characterized by fever lasting at least two consecutive days with a temperature ≥38°C. Common causes include dengue, malaria, typhoid, urinary tract infections (UTI), chikungunya, leptospirosis, and meningitis. Changes in hematological parameters such as anemia, thrombocytopenia, leukopenia, and leukocytosis are observed in AFI patients, which may aid in early diagnosis and management. Objective: To evaluate and compare hematological parameters among various acute febrile illnesses. Methods: A cross-sectional study was conducted from December 2023 to March 2024 among 60 AFI patients admitted to the Department of General Medicine at The Oxford Medical College Hospital and Research Centre, Bangalore. Patients aged ≥18 years with fever for at least two consecutive days were included, while those with septicemia, transfusion reactions, or allergic/drug reactions were excluded. Hematological parameters, including hemoglobin, WBC count, neutrophil count, lymphocyte count, and platelet count, were analyzed. Results: Among the 60 patients, 65% were male, with a mean age of 32 years. The most common AFI was dengue (38%), followed by UTI (22%), typhoid (17%), malaria (10%), leptospirosis (7%), and meningitis (7%). Significant hematological variations were observed across different AFIs (p<0.01). Anemia (Hb <11 g/dL) was most prevalent in malaria (83%) and meningitis (75%). Leukopenia (WBC <4000 cells/mm³) was primarily seen in dengue (30%). Neutrophilia (>70%) was most common in UTI (62%) and meningitis (75%), while lymphocytosis (>40%) was frequently noted in dengue (39%). Thrombocytopenia (platelets <100,000 cells/mm³) was most prominent in dengue (87%) and malaria (66%). Conclusion: Hematological parameters can serve as valuable diagnostic indicators in AFI, aiding in early diagnosis and timely initiation of treatment before confirmatory test results are available
Objective:
Table 1: Various acute febrile illnesses
|
Acute febrile illnesses |
Frequency (n=60) |
Percentage |
|
Dengue |
23 |
38% |
|
Urinary tract infection (UTI) |
13 |
22% |
|
Typhoid |
10 |
17% |
|
Malaria |
6 |
10% |
|
Leptospirosis |
4 |
7% |
|
Meningitis |
4 |
7% |
Table 2. Comparison of hematological parameters in various acute febrile illnesses (n=60).
|
Haematological parameters* |
Dengue (n=23) |
UTI (n=13) |
Typhoid (n=10) |
Malaria (n=6) |
Leptospirosis (n=4) |
Meningitis (n=4) |
|||||||
|
No. |
% |
No. |
% |
No. |
% |
No. |
% |
No. |
% |
No. |
% |
||
|
Haemoglobin (gm/dl) |
<11gm/dl |
9 |
39% |
8 |
62% |
6 |
60% |
5 |
83% |
1 |
25% |
3 |
75% |
|
>11gm/dl |
14 |
61% |
5 |
38% |
4 |
40% |
1 |
17% |
3 |
75% |
1 |
25% |
|
|
WBC (cells/mm3) |
<4000 |
7 |
30% |
0 |
0% |
2 |
20% |
1 |
17% |
0 |
0% |
0 |
0% |
|
4000-11000 |
12 |
52% |
8 |
62% |
6 |
60% |
4 |
67% |
3 |
75% |
3 |
75% |
|
|
>11000 |
4 |
17% |
4 |
31% |
2 |
20% |
1 |
17% |
1 |
25% |
1 |
25% |
|
|
Neutrophil count |
>70% |
6 |
26% |
8 |
62% |
4 |
40% |
2 |
33% |
1 |
25% |
3 |
75% |
|
<70% |
17 |
74% |
5 |
38% |
6 |
60% |
4 |
67% |
3 |
75% |
1 |
25% |
|
|
Lymphocyte count |
>40% |
9 |
39% |
0 |
0% |
2 |
20% |
1 |
17% |
1 |
25% |
1 |
25% |
|
<40% |
14 |
61% |
13 |
100% |
8 |
80% |
5 |
83% |
3 |
75% |
3 |
75% |
|
|
Platlet count (cells/mm3) |
<50000 |
13 |
57% |
0 |
0% |
1 |
10% |
2 |
33% |
0 |
0% |
0 |
0% |
|
50001-100000 |
7 |
30% |
0 |
0% |
1 |
10% |
2 |
33% |
0 |
0% |
0 |
0% |
|
|
100001-150000 |
1 |
4% |
2 |
15% |
2 |
20% |
1 |
17% |
1 |
25% |
1 |
25% |
|
|
150001-450000 |
2 |
9% |
11 |
85% |
6 |
60% |
1 |
17% |
3 |
75% |
3 |
75% |
|
*In all parameters p value <0.01 highly significant -chi square test.
Hematological parameters such as hemoglobin, WBC count, neutrophil count, leukocyte count, and platelet count can act as diagnostic indicators in patients with acute febrile illness. This helps in early initiation of treatment before the specific diagnostic tests result arise .
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